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. 2002 Jun;93(6):654-9.
doi: 10.1067/moe.2002.122588.

Oral histoplasmosis in Brazil

Orgânia Gomes Ferreira  1 , Sérgio Vitorino Cardoso, Aércio S Borges, Marcelo Simão Ferreira, Adriano Mota Loyola
Affiliations

Oral histoplasmosis in Brazil

Orgânia Gomes Ferreira et al. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Jun.

Abstract

Objective: We report 10 cases of histoplasmosis with oral manifestations seen in a teaching hospital in Brazil.

Study design: This is a retrospective study of the sociodemographic, clinicopathologic, and treatment data of these cases.

Results: Overall, 8 of 10 cases were seropositive for human immunodeficiency virus (HIV), whereas 2 were negative. The predominant oral manifestations found in HIV-seropositive patients were ulcers, oral pain, and odynophagia; both of the HIV-seronegative patients were symptom-free. HIV infection was suspected in 7 cases because of the presence of oral lesions of histoplasmosis. Asthenia, fever, weight loss, lymphadenopathy, and hepatosplenomegaly were found only in HIV-seropositive patients. Radiographs in 3 out of 10 patients suggested pulmonary involvement. Amphotericin B was the antifungal therapy chosen, and clinical remission of oral lesions occurred in an average of 30 days (accumulated doses: 500-1500 mg). Itraconazole was very effective as a follow-up treatment in terms of prevention of recurrence.

Conclusion: Histoplasmosis only rarely affects HIV-seronegative patients; however, the possibility of hidden immunodepression should be considered when oral manifestations of histoplasmosis are present.

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